Could Curbing Globalization Prevent Future Pandemics?

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CHAPTERS 

[00:00:00]: Study scope, methods, and key findings on delay 

[00:06:26]: Could delays help? Questioning potential advantages 

[00:09:03]: Enormous costs, undetectable preemptive benefits 

[00:10:49]: Historical precedents and disproportionate restrictions 

[00:12:43]: Vaccine rules; politicization and anti-migrant risks 

[00:14:00]: Are emergency border closures ever justified? 

[00:17:21]: Evidence across pandemics; local spread dominates 

[00:25:12]: Looking ahead: vaccines, inequality, and mobility 

TRANSCRIPT 

[00:00:03.520] 

Hi everyone. Welcome to Moving Beyond Pandemic, the podcast from the Migration Policy Institute that looks at how COVID-19 is reshaping all aspects of human movement, from tourism and business travel to labor migration and mobility. I'm Meghan Benton. I'm the research director for MPI's international work and for our sister organization, MPI Europe. So, pre-pandemic, we were living in a hyper global world. There were one and a half billion international tourism trips in 2019. 272 million international migrants, nearly 40 million flights. The drop in cross border mobility since the onset of the pandemic has been just staggering. Some are estimating a drop in 80% in travel and tourism in 2020. Permanent migration flows are down by 46% according to the OECD, at least in the first half of 2020. One of the recurring themes of this podcast has been whether and how it will be possible to return to pre-pandemic levels of mobility, how to do this safely, how to do this in a way that attracts public trust. But there's a looming question underneath all of this, which is will we ever return to normal? And how much was our way of life?

[00:01:21.160] 

So the cheap flights, the business trips, the normalization of long distance migration, the fact that people like me living transnational lives split between two or more countries, how much was all of this responsible for the way that the pandemic swept and then crippled the globe so, so rapidly? I spoke with Michael Clemens and Thomas Ginn from the center for Global Development about some deep dive research they've done on how travel and globalization contributes to the spread of pandemics. They asked the provocative question of how much you'd need to cut across border mobility to curb the spread of future pandemics. I also probe them a bit on whether travel restrictions can work in emergency times and in different phases of the pandemic. Hi, Michael. Hi, Thomas.

[00:02:18.940] 

Hello.

[00:02:19.660] 

Hi, Meghan.

[00:02:20.700] 

Hi. Thanks so much for joining me. You recently wrote a terrific paper about international travel and migration and the spread of pandemics. I just thought we could start by talking a bit about it. What's your overall argument?

[00:02:35.980] 

Great, thank you. Thank you again so much for having us. So, yeah, we wrote this question kind of motivated by the question of after COVID and kind of when there are no more kind of pandemic diseases to be worried about that are, that are ongoing, what should international travel and migration kind of really look like? So we know that there's kind of... It's intuitive to think about. Disease is spread through international travel and so may more international travel must maybe mean more spread of the disease, and so should travel be reduced in order to prevent spread of the disease? So the specific question is whether permanently reducing mobility in time periods between kind of known pandemics could reduce mortality for the country of incoming travel. And so we use both a simple model and examining the empirics of pandemics from 1889, 1918, 1957, and 2009 to kind of come to some initial conclusions and points of view here. So our punchline really is that reducing mobility could delay the expected arrival date. But it's really important to think about the magnitude of this might be really small. So, for instance, reducing travel by 50%, that's a really draconian impact of reducing travel might by, say, one to two weeks of delay for the disease arriving.

[00:04:16.310] 

But then when we look at the impacts on the final mortality and the overall impact that we think is kind of most meaningful, we don't see that this delay would have meaningful impacts on the total mortality once the pandemic is kind of finally gone.

[00:04:36.870] 

Can I jump in, Meghan? I want to just highlight a point that Thomas is making, which is that we are not talking about travel during a pandemic emergency. That is, we're not asking what should the U.S. Policy toward travel have been in February or March of 2020. We're asking if the extent of globalization has manifested in human mobility last year, let's say August of 2019, if the interconnectedness of people in the world through travel and migration before the pandemic happened, before anybody knew when it was going to happen, before anybody knew from where it was going to happen, is associated with greater harm when the pandemic hits. And, you know, as Thomas said, it's so intuitive for people to think, look, this pathogen comes by travelers. The more travel there is, the more chance there is for a pathogen to arrive. And you're trading off the private benefits of globalization with the public harms of sickness and death. In that sense, limiting globalization in general, not emergency travel restrictions once a pandemic hits, but before it even hits, could be thought of along the same lines as a speed limit for your car that is set in order to trade off the benefits of faster travel against the public costs of risk of accidents and that sort of thing.

[00:06:09.550] 

And really, you can see what Thomas is saying is that we're arguing that it's not like a speed limit at all, in that we don't see a public health benefit from limiting migration and mobility in general before the pandemic strikes.

[00:06:26.190] 

So I definitely want to push you on the question of emergency limitations as well, because I think that's the policy question on the table, the one that most people are interested in and where we are in this and this current pandemic. But just to take your point on its own terms, so if we had had this speed limit on travel and mobility and there had been more of a delay, would that potentially have been advantageous for certain countries who got COVID later? I mean, it was one of the arguments that's often made that a delay can be quite valuable. It buys you time to prepare other policy interventions and learn lessons from other places. And this pandemic has been a rocket speed pandemic. You know, we've had vaccines developed in six months. Is it possible that a delay could actually be quite valuable?

[00:07:22.570] 

So this is a great question, kind of exactly the way we're trying to think about this as well. So exactly as you say that if we kind of left, left travel kind of going, then we would, if we reduced travel at all, we would expect some delay in the arrival of, of of the disease. And could that buy us some kind of time? So we would first definitely advocate kind of continuous preparation and you know, continuous kind of learning from other countries, kind of regardless of the time. And when the pandemic starts, that, that's just really important. In general, the key point that we're trying to make here is that reducing travel by any kind of meaningful amount, even if you reduced it drastically, would only buy a very small amount of time. So we're talking about one or two weeks, potentially with a reduction of about 50%. And so in that time window, what we're, what the regressions that we're running and kind of the empirics are showing is that we eventually kind of don't see that that slight delay really has an impact at the kind of conclusion of the pandemic.

[00:08:39.020] 

So that's essentially the question that we're trying to answer with some of these empirics here is when we do see this delay from, reduce from countries that kind of have less incoming travel versus more incoming travel, do we see that those countries then have lower mortality at the end? And we really just don't see that from the empirics directly.

[00:09:03.200] 

And not just that, but we're finding just no systematic benefit. Although as you say, in principle there could be a benefit. It could be that one or two weeks allows you to do something critical. But beyond that, I want to highlight that what we're talking about here is measures that would drastically restrict for an indefinite period, all mobility for many years, perhaps decades before such an event. That's what would produce this hypothetical benefits that we can't see. So really we're talking about absolutely enormous, not just economic losses, but potentially losses for pandemic surveillance, potentially losses for the, the global interchange of scientific knowledge and expertise whose fruits we are now seeing in this global effort to develop a vaccine. The loss of all of that over an indefinite period when we don't know where the pandemic's going to come from, when we don't know when it's going to strike, just so that we could get one or two weeks. When it finally does strike, the benefit better be large. And on top of that we can't even detect a benefit.

[00:10:18.840] 

I mean, is there a real target here with that argument? So I haven't actually seen anyone propose attacks on globalization, attacks on travel of the kind that you outline in the paper. What are the kind of real world interventions that are actually on the table that you have in mind here?

[00:10:40.440] 

Believe it or not, there are economists who have proposed such things.

[00:10:44.200] 

I don't, I'm not in the right circles. Clearly.

[00:10:49.730] 

There's a seminar next week that I'm going to attend in Australia with some of the leading thinkers on global migration, asking if it's now an end of an era of global mobility and is that a good thing, given that we are so salient to so many of us now, are the potential costs of people moving so freely across borders? Certainly in the past we've seen very extensive, long lasting measures to limit or block migration justified by health concerns, not during a health crisis, but for long afterward. One that comes to mind is the Chinese Exclusion era of the United States, which went on for 83 years, several generations, and at its beginning was justified by many politicians with some real health crises that did occur when typhus, leprosy, syphilis in isolated cases did come via Chinese travelers to California. But the response of very severely restricting that entire migration corridor for many generations was just wildly disproportionate and longer lasting than the crisis, even if it had been justified during the crisis. And that is also questionable.

[00:12:13.290] 

I mean, is there perhaps is one potential real world application right now? Conversations about whether passengers should be paying for COVID testing or any costs that will be associated with having a vaccine as a requirement for moving. Those sorts of things will inadvertently mean that people pay more for their travel. I mean, as will just the cost of flights going up. Travel is likely to be more expensive, but not in the form of a tax.

[00:12:43.300] 

Those sound entirely appropriate to me. Although we have not studied the economics of such measures, I don't think that a vaccine requirement to travel is a draconian limitation on globalization. Many, many countries have required you to get a yellow fever vaccine in the Americas in order to go there for decades, certainly since I was a boy and long before. And that hasn't been, that hasn't crippled mobility in this region. But I think what we're certain to see is for many years to come, the still extraordinarily strong anti-migrant movement in many countries will feed off the fears and experiences of people during this pandemic to justify, even in direct and even in indirect and emotional ways, the limitations on migration or just the failure to expand lawful pathways for migration out of a generalized distaste for the subject of foreigners.

[00:14:00.980] 

And I promised we'd return to the question of emergency measures. This sort of permanent restrictions to mobility is, as you say, a kind of future pandemics question. But the current pandemic, we're still having conversations about whether border closures are justifiable under any conditions. And a distinction is often made between the containment phase. So when perhaps you have sufficiently low cases that you're able to trace them to essentially create a watertight border, which is I think, the situation that Australia and New Zealand found themselves in now they're trying to create a sort of biosecure border, have sufficiently low number of cases that you can manage it. Do you see emergency measures as justifiable at that phase?

[00:14:53.100] 

So yes, there is definitely a world in which we can kind of see emergency travel restrictions as justified and potentially helpful. And again, as you said, that's really not where our kind of paper and where our expertise or where the evidence that we're generating is kind of speaking to, we are allowing for kind of emergency restrictions to really potentially ramp up and potentially be very effective or not once a pandemic is identified and we kind of know that the pathogen is spreading. But to kind of address your question directly, so now that we are in this world currently with COVID and with kind of situations like New Zealand and Australia, there very well could be in this, you know, in this kind of containment phase of either where you know that a pandemic is spreading but you don't have any confirmed cases, it's possible that an emergency travel restriction can be effective. Although the public health literature is not very kind of high or positive on uncertain things necessarily, or if you're in the case of New Zealand, where you've kind of crushed the reproductive rate and where kind of you'd be reintroducing the disease mostly by kind of travel that you could, there could be a role for emergency travel restrictions.

[00:16:30.500] 

There's also the, the sort of upper threshold, so we're talking about like the lower threshold of cases where, as you say, New Zealand has kind of crushed COVID and has very few cases. But there's also when you're trying to reduce travel of all kinds, which is the situation that a lot of countries found themselves in earlier this year. So it's sometimes described as the mitigation phase. They're trying to reduce all human interactions and mobility of all kinds of. And border restrictions becomes a very easy way to do that and also prevents the sort of thousands of people funneling through points of entry problem. In many ways airports are like massive sports stadiums and if you lock down sporting events, you might also want to lock down airports. Do you think emergency measures work in that phase?

[00:17:21.480] 

So here there's some evidence that we present and there's evidence from public health experts as well. What we do in our paper is put together for the first time the rate of spread in a comparable way between these four past influenza pandemics. 1889-1918-1957-2009. And you can compare them with the coronavirus pandemic asking the question, for example, after international spread began, When were each grouping of people on Earth reached by the pandemic? How fast did it spread around the world? And I say grouping of people because country borders changed a lot over that time period. And what we do is do the analysis in a way that holds country borders constant. That is, we're talking about when did the pandemic of 1889 reach the area of land that is today for Sudan, for example, compared to when coronavirus reached Sudan. And the bottom line is that for the median person on Earth, the Coronavirus pandemic actually arrived slower than the 1889 influenza pandemic. So racing across the world started in what's now Uzbekistan. Within a few months, it had gone all around the world and it had actually touched these areas of land. Today's modern countries, where more than half of the population of the world was living sooner than coronavirus, did that.

[00:19:08.270] 

Think about 1889, where people are still traveling by sailing ship in some cases, by any measure, the speed and extent of international travel, international migration are, are less than a tenth of what they are today, and you still get comparable rates of spread and really the reason that happens is because of the point that you're getting at of during this mitigation phase, once the virus has arrived in your country very, very rapidly, the way that epidemic dynamics play out is that the you are very quickly at a much greater risk of catching the pathogen from locals rather than new arrivals. And a team at the London School of Hygiene Tropical Medicine and the University of Hong Kong actually did this calculation for May of 2020 if nothing had happened to travel. That is, there were no emergency travel restrictions in the world in 2020 and no change in the willingness of people to travel in 2020. So just take the levels of travel between countries from the previous year, May 2019, apply them to May 2020, and then ask what fraction of the incident infections, the new infections that people were acquiring in May of this year would have been from travelers and would have been from locals by that time.

[00:20:41.850] 

And the answer is that for the vast majority of countries on Earth, it would have been less than 10% of incident infections would have been from travelers. And for about half the countries on Earth, it would have been less than 1% of incident infections would have been coming from travelers. And again, this is even if nothing had happened to travel. So basically, when the pathogen gets to your borders, and that is going to happen relatively soon, if you have any meaningful degree of connection with the world, unless you're just totally cut off or a very isolated island very, very soon, the risk is from other locals. It has nothing to do with people arriving from abroad. And then domestic measures are paramount. Mask wearing, domestic mobility, are people staying at home, are people going to mass gatherings, all of the things that countries have been doing to very, very different degrees. And that is why the country, Thailand, which had the first case outside of China, January 13, a week before the United States, Thailand had before the pandemic twice as many travelers from China each day as the United States did. And here we are late in this year, at this moment, with the, the Thai mortality rate from this pandemic.

[00:22:08.260] 

If Thailand had the same population as the United States, with their mortality rate, there would have been 284 total cumulative deaths to date, while here we stand with 250,000 in the U.S. so clearly, I might add, that Thailand didn't actually restrict China from travel until late March. The United States did it on January 30th. This is an illustration, not a proof, but an illustration of the paramountcy of behind the border interventions. What countries are doing to restrict interactions between people inside the country to change the probability of transmission at those interactions inside the country are vastly more important than the degree of interconnection, which again was much greater for Thailand and China than the U.S. And China and even the degree of or exact timing of travel restrictions.

[00:23:11.610] 

There's such a gap, isn't there, between what the public thinks works and the sort of desire for these big symbolic gestures and what the evidence says? I think it was interesting. Well, you mentioned the UK academics who put together that study. But it was interesting that the UK had some scientists advising it on border policy and resisted introducing quarantine and border measures when other countries had. But then under quite a lot of public pressure decided to follow suit and they tried for a while to say, oh, but you know, community spread is such that it won't make any difference. But it was described as the number one concern that constituents reported to MPs. So it's an interesting challenge for us as, as researchers. I think.

[00:24:02.370] 

I think it's exactly right. I think we kind of, you know, we know that the disease came from abroad and. Right. In every country except for one where it originated. Right. It came from someone traveling abroad who brought it. And we just, it's very hard to get that kind of mental, mental image kind of overturned of where the kind of most threat is coming from then as the pandemic evolves. But as you say, the evidence says otherwise. I mean, now. So at the beginning stages of the pandemic, of course, you know, Chinese travelers to the United States, for instance, represented obviously they had a higher chance of potentially of bringing COVID to the United States. But now, you know, a Chinese traveler coming to the U.S. Would decrease the prevalence in the U.S. On average because the disease is so much lower there than it is here that you know, it's very hard to kind of get that, to reverse that mental image and kind of make that stick for people.

[00:25:12.590] 

Okay, so final question. I'm going to push you back into the the real world. We're having this conversation, but in many ways the stable door is open, the horse is bolted. We already have border closures, we already have conversations about health screening and we are facing, I think another year 2021 with quite significant restrictions to mobility. I mean, one thing I've been thinking about is if you have vaccine take up are highly differentiated rates and then there's a real global imbalance in infection spread. What happens then to discussions about reducing mobility?

[00:26:00.950] 

We talked before about how greatly different prevalence of vaccine take up need not be a major barrier to global mobility. I talked about yellow fever earlier very few Americans have a yellow fever vaccine because there isn't yellow fever in the United States meaningfully. But for many countries to go there, they want you to have yellow fever vaccine and alongside your passport you need to prove that you're vaccinated against yellow fever. That the requirements to get vaccinated for travel in the presence of a cheap, quick and highly effective vaccine need not cripple mobility, even in the presence of vast differences in the fractions of populations that are vaccinated. So very low access to the vaccine initially in low income countries, which is highly problematic for many reasons unrelated to mobility, but is likely to be the case, need not cut them off from global travel.

[00:27:10.760] 

Thomas?

[00:27:12.440] 

Yeah, I mean, I would totally agree. I mean, I think we're kind of have so far been kind of operating in a world where there is no vaccine, as we kind of talked about earlier. Right. Even those emergency travel restrictions in most cases are really kind of not buying us very much. So in a world where more people are vaccinated and we can kind of reduce the global spread, that's obviously going to help, but doesn't necessarily mean that then we should all of a sudden make the vaccine kind of the only way that people can travel. Obviously we want that kind of as widely spread available as possible, but just kind of reducing the overall travel, the overall spread of the pandemic will help kind of everywhere that any kind of the more connected world overall.

[00:28:04.840] 

Great. Well, thank you so much both of you. This has been a really interesting discussion. Thanks for your time.

[00:28:09.400] 

Thank you very much.

[00:28:10.680] 

Thank you, Meghan.

[00:28:13.880] 

I really like Michael's metaphor of a speed limit. So even if you severely cut migration and mobility, it would barely make a dent on the global spread of an epidemic. So only offer a delay of a matter of days instead. As he said, what really makes a difference is domestic measures. So travel restrictions can actually be a distraction if they're basically symbolic crowd pleasing measures that detract from a thoughtful policy response. I also thought it was interesting that their research finds that previous pandemics have spread faster if you control for other factors. So there isn't something special about the 21st century and its particular brand of globalization that makes us more susceptible pandemics. Of course the question on the table for this pandemic isn't what conditions stop initial spread, but how and whether we should prevent travel and mobility even within countries as part of a rafter social distancing measures, especially while we await production and take up of vaccines. And I still think that there's a research gap there. We're really missing some crucial evidence, and I warmly invite anyone working on this topic or who has any thoughts on this to get in touch with me.

[00:29:27.970] 

In the meantime, if you want to hear more, you can subscribe to this podcast, Moving Beyond Pandemic wherever you find your podcasts, you can also access it through our website, which is migrationpolicy.org/podcasts and you can find Michael and Thomas's paper on their website, which is cgdev.org. I'd like to to thank my colleagues Lisa Dixon, Michelle Mittelstadt and Kenia Guerrero for producing this podcast. And the music you heard today was Juno in the Space Maze by Loopop. I'm Meghan Benton. I will see you next time.